Development of a Personalized Attention Training Program for Pediatric OCD

为儿童强迫症制定个性化注意力训练计划

• 批准号: 8665493
• 负责人: Susanna W. Chang
• 金额: $ 19.25万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-16 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8665493
• 关键词: Adult; Advanced Development; Affect; Aftercare; Anxiety; Attention; Behavioral; Biological Markers; Case Series; Child; Childhood; Chronic; Clinical; Cognitive; Computers; Data; Development; Educational Intervention; Emotional; Exhibits; Family; Feedback; Foundations; Future; Generalized Anxiety Disorder; Goals; Health Services Accessibility; Intervention; Intervention Studies; Intervention Trial; Investigation; Literature; Measures; Mediation; Mediator of activation protein; Modification; Monitor; National Institute of Mental Health; Obsessive-Compulsive Disorder; Parents; Patient Self-Report; Patients; Pattern; Performance; Pharmacological Treatment; Phase; Population; Procedures; Process; Protocols documentation; Psychosocial Assessment and Care; Public Health; Randomized; Randomized Controlled Trials; Regulation; Relative (related person); Research; Risk; Sampling; Services; Severities; Social Phobia; Stimulus; Strategic Planning; Symptoms; Temperament; Testing; Training; Training Programs; Translations; Youth; avoidance behavior; base; clinical anxiety; cognitive control; computerized; conflict resolution; effective therapy; evidence base; executive function; expectation; follow-up; improved; indexing; information gathering; innovation; neuromechanism; novel; programs; relating to nervous system; research study; response; theories; tool; trait; treatment program; treatment response; young adult

DESCRIPTION (provided by applicant): Pediatric Obsessive Compulsive Disorder (OCD) is a chronic, impairing condition that accrues significant concurrent and long-term risk to affected youth. Although a number of empirically supported treatments for OCD exist, many children and their families are either not able to adequately access these treatments or derive only partial benefit from them. Such findings highlight the importance of developing more efficacious treatment options, which have the potential to be widely accessible to youth with OCD. Recent efforts to improve existing treatments for anxiety, including OCD, have emerged from the established experimental literature on threat-related attentional bias in anxiety. This novel theory-driven treatment utilizes computer-based attention training protocols to directly but implicitly modify biased attention patterns in anxious patients in service of symptom relief. The rapidly accumulating evidence base for attention training suggests it may be a promising new intervention for anxiety; however, the extant research has been largely conducted with non-clinical anxiety samples and primarily with adult populations. Thus, we propose a developmental translation of basic findings from experimental research on cognitive biases in anxiety into a novel computer- based attention training intervention for pediatric OCD as an initial step towards demonstrating its feasibility, acceptability and preliminary efficacy. To date, no study has investigated attention training in pediatric OCD, although there are positive findings in adults and children with Social Phobia, Generalized Anxiety Disorder, and sub-clinical OCD. The proposed study will be conducted in two phases. Phase 1 will entail protocol adaptation and development in conjunction with the treatment of an open case series of six children. Phase 2 will involve a small randomized controlled trial (n = 52) that will evaluate the acceptability, feasibility and preliminary efficacy of an eight-session computerized attention modification program versus an attention control condition in reducing attention bias to threat and overall symptom severity in youth with OCD. In addition, a three-month follow-up will be included to gather initial data on durability of treatment gains. We also propose to investigate in an exploratory manner the potential relationship between attention training and changes in behavioral and electrophysiological correlates of cognitive control and affect regulation before and after treatment with AMP or ACC. Preliminary investigation of the relationship between neural indices, baseline attention bias as well as temperament-related ratings of attention control may begin to elucidate potential predictors/moderators of this novel treatment for childhood OCD. Our expectation is that feasibility and preliminary efficacy findings from this project will inform the development of a future large-scale intervention trial, which will hopefull further advance the development of innovative, personalized interventions studies consistent with NIMH Strategic Plan's Objectives (3.1).

描述（由申请人提供）：小儿强迫症（OCD）是一种慢性，损害的疾病，对受影响的年轻人产生了重大的并发和长期风险。尽管存在许多经验支持的OCD治疗方法，但许多儿童及其家人无法充分获得这些治疗方法，或者仅从中获得部分损益。这样的发现凸显了开发更有效的治疗选择的重要性，这些治疗选择有可能被强迫症青年广泛使用。既有有关与威胁有关的焦虑症偏见的既定实验文献的最新努力，包括强迫症在内的焦虑症，包括强迫症。这种新型理论驱动的治疗利用基于计算机的注意力训练方案直接但隐含地改变了焦虑的患者以缓解症状的偏见。注意训练的迅速积累的证据基础表明，这可能是一种有希望的焦虑干预措施。但是，现有的研究主要是通过非临床焦虑样本进行的，主要是由成人人群进行的。因此，我们提出了从焦虑中认知偏见的基本发现的发展转换，以便为儿科OCD提供基于计算机的注意力训练干预措施，这是证明其可行性，可接受性和初步功效的第一步。迄今为止，尚未研究小儿强迫症的注意力培训，尽管成人和患有社交恐惧症，广义焦虑症和亚临床上的OCD的儿童有积极的发现。拟议的研究将分为两个阶段。第1阶段将需要协议适应和发展，并结合对六个孩子的开放式案例系列的处理。第2阶段将涉及一项小型随机对照试验（n = 52），该试验将评估八阶段计算机化注意力修改程序的可接受性，可行性和初步疗效，而不是注意力控制条件，从而减少了对OCD青年的威胁和整体症状严重性的注意力控制条件。此外，将包括三个月的随访，以收集有关治疗持续性持久性的初始数据。我们还建议以探索性调查注意力训练与认知控制的行为和电生理学相关性变化之间的潜在关系，并影响用AMP或ACC处理前后的调节。对神经指数，基线注意力偏差以及与气质控制的关系之间的关系的初步研究可能会开始阐明这种新型儿童OCD治疗方法的潜在预测因子/主持人。我们的期望是，该项目的可行性和初步疗效发现将为未来的大规模干预试验的发展提供信息，这将使人们希望进一步发展与NIMH战略计划一致的创新性，个性化的干预研究（3.1）。

项目成果

The ERN as a neural index of changes in performance monitoring following attention training in pediatric obsessive-compulsive disorder.

ERN 作为小儿强迫症注意力训练后表现监测变化的神经指标。

• DOI: 10.1016/j.biopsycho.2021.108206
• 发表时间: 2021
• 期刊: Biological psychology
• 影响因子: 2.6
• 作者: Tan,PatriciaZ;Rozenman,Michelle;Chang,SusannaW;Jurgiel,Joseph;Truong,HollyV;Piacentini,John;Loo,SandraK
• 通讯作者: Loo,SandraK